The primary goal of this proposal is the design of small molecule compounds which target newly identified protein structures with direct relevance to insulin secreting 2-cell viability in type II diabetes. Islet amyloid polypeptide (IAPP) is a 37-residue peptide hormone, which is co-secreted with insulin by the 2-cells of the endocrine pancreas. IAPP belongs to a class of aggregation prone proteins, which includes A2 from Alzheimer's, in which a wild-type protein precursor irreversibly forms/folds into 2-sheet rich fibrillar amyloid plaques. The origin of 2-cell death in type II diabetes is poorly understood. Like most amyloid diseases, it is the presence, rather than the extent, of amyloid deposition that is correlated with pathology. Instead, it is the intermediates of the assembly reaction that have been implicated in cell death. Importantly, this cytotoxicity is mediated by the formation of membrane bound protein structures. In the case of IAPP, this is highly intriguing since, despite the 2-sheet nature of mature amyloid, membrane bound states are 1-helical. The overall hypothesis pursued by this proposal is that small-molecule, structure based targeting of pre-amyloidogenic states will enable elucidation of the mechanism of IAPP induced cytotoxicity. These efforts will provide novel descriptions of IAPP oligomerization at a molecular level, and provide a rational design path for the creation of lead compounds that ameliorate 2-cell death. Our concurrently pursued aims include synergistic efforts in synthetic chemistry, cell and structural biology. Importantly, we will target the 1-helical intermediates of IAPP by synthesizing small molecules designed to mimic the surface presentation of one edge of an 1-helix. Cellular methods will be developed to assess toxicity and localization of IAPP. Diffraction, NMR and computational methods will be employed to elucidate the alternative oligomeric states at atomic resolution and to provide structure based guidance for small molecule synthesis.